Depression No More (2): Diagnosis

We have all felt ‘depressed’ at one time or another due to the many different things that happen in our lives. Sometimes it can be due to poor communication with our family or our friends, or a difficult teenage child, seasonal changes, hormonal changes, difficulty at work, business is not going well at the time, problems in a marriage, career dissatisfaction, unpleasant childhood experiences, difficult parents, and the list goes on. These can cause us to feel depressed, but do not necessarily indicate a disease.

If depressed mood or loss of interest or pleasure persists for more than at least a two-week period, consider the diagnosis of major depressive episode. The diagnostic criteria are summarized below:

At least five of the following symptoms have been present during the same two-week period, nearly every day, and represent a change from previous functioning.

(1) depressed mood (or alternatively can be irritable mood in children and adolescents)

(2) Markedly diminished interest or pleasure in all, or almost all, activities

(3) significant weight loss or weight gain when not dieting

(4) Insomnia or hypersomnia

(5) psychomotor agitation or retardation

(6) fatigue or loss of energy

(7) feelings of worthlessness or excessive or inappropriate guilt

(8) diminished ability to think or concentrate

(9) recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide

If symptoms do not subside, depressed mood could become depression, then depression could advance and require treatment. Feeling depressed about a situation might be a motivation for changing the situation. However, clinically diagnosed depression is a type of mental illness and can be distinguished from a depressed mood by its persistence and severity. Those with clinically diagnosed depression have depression persistently everyday for long periods of time. It interferes with their ability to cope at home, at work and in daily life. It is a disorder, an illness, just like diabetes, ulcers, or hypertension and treatment is required.

Depression occurs when neurotransmitters, such as serotonin or epinephrine, are either at low levels or not functioning properly (neurotransmitters are specific chemical agent released by a pre-synaptic cell, upon excitation, that crosses the synapse to stimulate or inhibit the post synaptic cell). Key symptoms are feeling down, weepy, pessimistic, useless, hopeless, irritable, agitated, low sex drive, poor appetite or suddenly overeating, or lack of motivation.

Depression can become a problem if left untreated and it’s critical to get help in the early stages before it becomes too severe. Early intervention may include many alternative therapies such as group therapy, counseling, Tai Chi, Qi Gong, Acupuncture or Chinese massage, Martial art, Daoist study, etc. In United States, there are other non drug alternative therapies available.

In my experience with healing depressed patients, many of them feel better when treated with either Chinese medicine or from practicing Tai Chi, some of them also take medication but eventually they are able to get off their medication and still feel good. I have lived and practiced medicine in two countries and have experienced two different life styles and cultures.